5 replies to this topic

[LivingWellWithCML]

Hi everyone,

 

Question about my 3-month Gleevec dosage reduction experiment (I'm approaching month 1).  Since I have plenty of Gleevec 400mg tablets, the doc suggested that I score the existing tablets to get 200mg/daily.  He didn't seem concerned with the accuracy issues inherent in scoring (e.g., I guess it could be off by a few mg?), but I wanted to see if others have scored Gleevec for an extended period (> 1 month) and was everything okay?

 

Since this is a short-term experiment and probably due to cost issues, we did not change my prescription or switch to 100mg tablets.  I've just been using a pill splitter to score what I have.

 

What's the risk in scoring Gleevec 400mg tablets for a 200mg dosing schedule (using a pill splitter)?

 

 

[Trey]

The pills were already scored when I took 400mg pills, and I split them by hand and took half morning and half evening.  Maybe that has changed.  Now I take 100mg pills. 

 

The biggest issue with splitting 400mg pills for me was the large jagged end.  I needed to get the small end going down first.  I have a tougher time swallowing pills since taking TKI drugs, probably due to edema of soft tissues, or possibly slight thyroid swelling caused by TKI drugs.  Not sure which it is.

[TeddyB]

Hey Dan, glad to hear you are trying to reduce dosage.

 

Dont think there would be much risk when using a pill cutter, just get them down fast so you avoid the fun gleevec taste.

 

If they are hard to swallow, try the 100mg pills, i am 4x100mg daily

 

Good luck, you might want to check out the Destiny trial ongoing in the UK, some info here: http://www.cmlsupport.org.uk/node/8571

 

Its a reduced dosage then stop trial, and so far from what i read, most people are doing well.

[LivingWellWithCML]

Wow @TeddyB - the thread you shared is very encouraging!  I appreciate you sharing it.  Fortunately, I'm having no issue splitting and swallowing the 1/2 doses.  At this point, it's more the general concern I have with taking a smaller pill and what might be happening to my PCR during this 3-month period?!?  I'm largely pretty calm about it, but after a month of this routine, I am getting just a littttttle bit anxious. 

 

I'm not bike-ready yet, but my right knee has improved SIGNIFICANTLY over the past month - and this is after a full year of nasty pain, daily swelling, ice packs, etc.  Note that this all started after a road cycling overuse injury, so it's more the lack of healing as the source of the pain rather than Gleevec just causing random joint point.  But I appear to be healing on 200mg vs. 400mg.

 

Truth be told, if I didn't have the joint pain, I would've stayed on 400mg.  I don't necessarily have a strong desire to explore reduced dosage or cessation at this point in time, but this is where my journey has led me - so we'll see what's next.

 

@Trey - yup, the 400mg tablets are still scored.  I have a good pill splitter, so it's a pretty clean and easy-to-consume 1/2 pill after it's split.

 

Just to make sure, are there any absorption or efficacy risks associated with splitting a scored dose vs. taking two 100mg tablets?

[gerry]

Good news on knee getting better. 

[Trey]

"..are there any absorption or efficacy risks associated with splitting a scored dose vs. taking two 100mg tablets?"

 

No.  The pill contents are well mixed and very close to full diffusion.

 

Another answer is that this is not a contest where we "keep scores".  If someone scores higher, and then some a$$hole cuts the score in half, did we lose?  I say not.  But if then you cut the scores, but henceforth take it times "dos", then in Texas at least you have again doubled it.  But cutting in half and doubling may not yield the original result (ask PhilB, who is the Exchequer to the Queens Royal Maths and Sewer Works Society).  Hence, if you wish to cut the scores, be my guest.  But I will henceforth and forevermore refuse to play this little game again.  nuff' said about that little issue. 

 

This will bore the sharts out of you but I will post it simply for that effect:

http://highered.mhed...sion_works.html